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Home My WebLink AboutHIGHLAND TERRACE #5 LT 1Highland Terrace #5 Lot 1 #050-312-31 Municipality of Anchorage ;•''' Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 2 www ci.snchoraga.ak.us (907) 34}7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50251 PID Number. 050-312-31 ;A*YNE AND JOYCE SIMM NS Wastewater System: ❑ New ® Upgrade Aearass )RRIE WAY EAGLE RIVER ABSORPTION FIELD Pnorr Nero« of e.addms 0 Dap Trwdl 0 Sh.nw TMrth 0 BW D Marg o Om LEGAL DESCRIPTION soa""�° TOW D.PetwnwprWpaW 0.8 GPDRP 10 Ft. Brock La SrEewNon Dapth to ppa bW= bon apnil V� Gr" d"M buratn ppa 1 HIGHLAND TERRACE R5 6.9 FI. 3 FI TowWip Rrpa Sw1 FA edwd mora a" 7ada Grn Lupin: 114N 1W 7 0.5 Fl. 66 Ft. Well: New [:1 Upgrade `"�" "°" Nwwwarw D.w MtwanY 5 Ft. 1 0 Ft Gluwbcaoan(Pmue. A B. Cp 7"DWM caaadm Twl sbaorpbon tor" Pp. MwwW EXISTING PRIVATE Ft. I FL 563 FP I ASTM 3034 olA Do* Dralad Swc Www LM Yatww Owa nwrw FL FLINSTONE ENTERPRISE 7/2912005 nwd Pump SMw Caavp Nw" Abova Goind TAN K GPM FI. FL SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubllr1povate « . tv From Tank Field Station Tank Sewer Line ANCHORAGE TANK 1250 ow Well +100' +100' .. — +2s Mww STEEL Nu a cwrpar s 2 Suhca Www +100' +100' — — LIFT STATION La Lw +5' +10' — — ua NO LIFT ow 1WaWvw +5' +10' — — 'Pure W. r w 'Pure Qtrr w Hph www wwm w. iouNwcn h ti h C~ Dnrl +50' /� +50' — Pump Mak@ a Modal Elow" trpadwna pwtwmM by Rarnarka' BENCH MARK Laalgrl wtl Deawvpron CORNER OF SIDEWALK AT GARAGE . .. aures Mvwwn. .w•. 100 FL En Inspections performed by: CHARLES BALZARINI Dates: 1N 712612005 A 2n° 712912005 Development Services Department Approval Conditional Approval Date: i CHRISTOPHERRWOOD CE1 387 Reviewed and approved by: Date: • m.. a adlFSSiOI�� Permit No. SW050251 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: HIGHLAND TERRACE#5 LOT1 1 1 SWING IIIES I M" msM, rrj_7_5_F2_5_1_f__5Z_;T I i 1 1 I Q - DMERTER O - CLEANOUT ; WELL I SNED EXISTING DRAINnELDTH-1 TO REMAIN •' DRIVEWAY• • .• GARAGE HOUSE �1 n CORNER OF SIDE ALK AT GARAGE • — MONITOR TUBE —,�— ASSUMED ELEVATION • IGD• ORLELEVATIONS LLEVELAATGR99.9 (NOT TO SCALE) HT -1 P.5' FILL MT -2 TH-1 97.0 TANK 1,250 GAL 92.0 P91 66 YPA P �vd.11 GRAVEL � . ff� ° Na •e % e ° e. _._88.9 82.9_ BOTTOM OF T.H. VALVE 050-312-31 SCALE T —05 ENGINEER'S SEAL =0000404 �,. OF .& .•.ear.:.... CHRISTOPHER R. WOOD �f ••,. QCE-10387 ��Ess � 1 F Is.1 ses I 1 1 1 Q I 3 � I w 1 � I o C U r % A. I i 1 1 I Q - DMERTER O - CLEANOUT ; WELL I SNED EXISTING DRAINnELDTH-1 TO REMAIN •' DRIVEWAY• • .• GARAGE HOUSE �1 n CORNER OF SIDE ALK AT GARAGE • — MONITOR TUBE —,�— ASSUMED ELEVATION • IGD• ORLELEVATIONS LLEVELAATGR99.9 (NOT TO SCALE) HT -1 P.5' FILL MT -2 TH-1 97.0 TANK 1,250 GAL 92.0 P91 66 YPA P �vd.11 GRAVEL � . ff� ° Na •e % e ° e. _._88.9 82.9_ BOTTOM OF T.H. VALVE 050-312-31 SCALE T —05 ENGINEER'S SEAL =0000404 �,. OF .& .•.ear.:.... CHRISTOPHER R. WOOD �f ••,. QCE-10387 ��Ess MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO50251 Legal Description: HIGHLAND TERRACE #5 LT 1 Design Engineer: 0848 Eagle River Engineering Services Owner Name: WAYNE & JOYCE SIMMONS Owner Address: 10925 CORRIE WAY EAGLE RIVER. AK 99577-8408 Date Issued: Jul 25, 2005 Expiration Date: Jul 25, 2006 Parcel ID: 050-312-31 Site Address: 010925 CORRIE WAY Lot Size: 43712 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: 0 Disposal Field R] Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. REMINDER: NEED TO MAKE SURE SEPTIC TANK MAINTAIN PROPER SETBACK FROM FOUNDATION AND ORIGINAL LEACHFIELD. AND LEACHFIELD NEEDS TO MAINTAIN PROPER SEPARATION FROM FOUNDATION AND LOT LINE OR APPLY FOR LOT LINE WAIVER. Received Date: Issued By: RI 1 Date: 24 a—/- i Municipality of Anchorage Development Services Department. Building Safety Division On -Site Water and Wastewater Program ,.,�.n 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us. (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FORA SINGLE FAMILY DWELLING Parcel I.D. 10 -942-51 Permit Number SW Property owners) Day phone log 1/ - 931 Mailing address (1) Mailing address (2) )Ke�VA4_ AL Zip Code 9°I5'77- 9'yo8' Legal description (Lot, Block & Sub'd.) _#z?A e" d Legal description (Section, Township & Range) Lot Size y3I 71;)-- Acres Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade Ell� THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information is correct. I further certify that this application is being made for a Single FarinjOwelli d is accord nce with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12100) i . /b Waiver Fees: X07 u� 0- Date of Payment: il �3� t 1/ Receipt Number: Eagle River Engineering Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 Eagle River, AK 99577 July 19, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: IIighland Terrace q5 Lot 1 Narrative & Permit Application Dear Mr. Roth: Services (907) 694-5195 tel (907) 694-3297 fax Eagle River Engineering Services (ERES) was contracted to design a septic system upgrade at the above referenced property. The homeowner wishes to upgrade their septic system, due to recent problems with backing up, and the age of their septic tank. A test hole and soils percolation test has yielded a percolation rate of 4 minutes per inch, and no water table. The soil type appears adequate to support a replacement 4 bedroom leachfield. The proposed 4 bedroom septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, so there is room for wells, septic systems and alternate sites. 2. Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 100' of the proposed septic system. 4. Drainage will not be affected and is not a major consideration in our design. Installation of this 4 bedroom upgrade will not adversely affect the wells or septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAGLE VE IN RING SERVICES Christopher R. Wood, P.E. Principal \2003\05-059SEPTICNARRATi V E Well I CORR/E 1 ` Myq\ ; t M1o90P'S PCSFPVE� , LEGEND WELL i ® — TEST HOLE m _ -I — EASEMENT �7 I I 1 DRIVEWAY � i 1 I I 1 1 `�. 1 i m PFL M-' T ® � I pVFAIEP Y/iLVE cl m } �� I MA SNIE' 3 ��, � DRAMVIO W '`I Prnuacnrnw� IM M $Lpnc--� / zo' 1 C MAGE U •I . Well �lc A7/ � N ` M1o90P'S PCSFPVE� 144 LEGEND WELL i ® — TEST HOLE m — DNERTER VALVE — EASEMENT i — PROPOSED LEACH FIELD EXISTING LEACH FIELD DRIVEWAY �' WP`( / • _ MONITOR TUBE dy ((P o CLEAN OUT 1. NO KNOWN CURTAIN DRAINS 1 , � 2. NO KNOWN SURFACE WATER WELL/SEPTIC SITE PLAN -*-'�OF%% LEGAL: HIGHLAND TERRACE #5, LOT1 �� -q Ns OWNER: WAYNE AND JOYCE SIMMONS �P ' � ## CONTRACTOR: UNKNOWN %* * ♦f JOB 04-047 DATE: 07/18/051 SCALE 1"= 50' i EAGLE RIVER ENGINEERING SERVICES �I� C' RISE° ioasi AP.O. Box 773294 EAGLE RIVER, AK. 9957707 694-3297 14k%' �ssIc `'41 (907) 694-5195 FAX: (9 ) .� Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Highland Terrace N5 Lot I May 2, 2005 A. GENERAL 1. The well and septic plan is for a 4 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — 1% minimum and insulated with 2" of burial foam if shallower than 3 ft., with 2 ft. minimum. 2. Septic Tank shall be a minimum of 1,250 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. C. DRAINFIELD 1. The drainfield is to be placed as shown on the site plan. Contractor shall take extreme care ensure that 10'separtation distance is maintained between the house and from the lot line. 2. The bottom of the drainfield excavation shall be level, plus or minus 1.5", prior to placing gravel. 3. The total depth of the drainfield excavation shall not exceed 10 ft. at any point in relation to natural ground surface. 4. The drainfield gravel shall be covered with typar fabric material. 5. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded or mounded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. \\Eres\docs%W PDOCS\2005\05-059drainficid- spcc.doc Eagle River Engineering Services Christopher R. Wood, P.E. RECOMMENDED LEACIIFIELD DIMENSIONS: TOTAL DEPTII = 10' GRAVEL DEPTH = 3' under pipe, 2" over pipe (3.5' total) DRAINFIELD LENGTH = 66 DRAINFIELD WIDTII = 5' SOIL RATING= 0.8 GPDIW BEDROOM CAPACITY= 4 total SEPTIC TANK = 1250 gallons min. Twenty-four (24) hours notice required for all inspections. \\Eros\docs\WPDOCS\2005\05-059dreinfreld- spec.doc EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD Suite 201 Eagle River, Alaska 99577 (907) 694.5195 ERES Project No.: 05-059 Calculated By. CW Date: 8/28/2005 Legal: Highland Terrace #5 Lot 1 TEST HOLE 1 Single Family 3 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = e minutes per Inch Wastewater application rate = 0.8 gallons per day per square foot Required absorption area - 583 square feet Trench width (W) = 5 feet Gravel depth (D) = 3 feet Required length - Shallow trench factor • Required absorption area / W Shallow trench factor = (W + 2)1(W + 1 +2 D) Shallow trench factor = 0.58 Total Excavation Depth = 10.0 feel Required length = Be feet 05.059 dralnfieldCalc 4:05 PM812812005 Municipality of Anchorage Development Services Department Budding Safety Division yt OnSite Water and Wastewater Program 4700 South Bragaw SL P.O. Boz 796650 Anchorage, AK 99519$850 www d anchoraae.ak.ua (1107) 343.7904 Tfl. — I- Soils Log - Percolation Test Performed For. Wayne CjrmmonS DatePerfonned: 61w ;; Legal Description: 7effaCe4+5 Lot Township, Range, Section: 114NrQIW,$CC.7 i H-2 Depth 1 17- 19 - WAS GROUND WATER ENCOUNTERED7 rW 9 IFYES.ATWNATOEPTH7 ..� L 0 Depth to Water Agar .- p MonRahgT E Datc / 0 Reading I Data I Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE Q �V^�`wl PERO HOLE DIAMETER TESTRUNBETWEEN FT AND q -S FT COMMENTS PERFORMED BY: ftr^r..JPS 9c, 1�20kr'6' I �✓''/��WW/CERTIFY THAT THIS T S WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2- . C, V1 3- S(1GtiTLy ST1-ll 4- 54NDa ARAOt--L 5- 6- 7- v 8- 9- 10. 11. 12. SA�Tte. 13- gororA i 1 17- 19 - WAS GROUND WATER ENCOUNTERED7 rW 9 IFYES.ATWNATOEPTH7 ..� L 0 Depth to Water Agar .- p MonRahgT E Datc / 0 Reading I Data I Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE Q �V^�`wl PERO HOLE DIAMETER TESTRUNBETWEEN FT AND q -S FT COMMENTS PERFORMED BY: ftr^r..JPS 9c, 1�20kr'6' I �✓''/��WW/CERTIFY THAT THIS T S WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION G ENzh'-!J %r I ENVIRONMENTAL ENGINEERING DIVISION G.4^C rLL r 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RUORT NAME CWC.rr '� PHONE - — -- — � '`fi -��3I ❑ UPGRADE MAILING ADDRESS _ �O, 77 LEGAL DESCRIPTION L _ 00 n/ LOCATION �r l�t�R-e ) L (iIJ,C�..vl NO. OF BEDROOMS Well ( Absorption rea DISTANCE TO: � Dwelling �� PERMIT NO. Y -�� /•� _ I- z Manufacturer %� �� Material No. of compartments in y i�Sc-fL L— �� [ C -L=C— y - Lin. capacity in gallons �.�,�-p IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling T PERMIT NO. r 02< Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well + +G% Foundation�� Nearest lot line /1,�� K/ PERMIT NO. 7� LL z No. of lines Length of each line Total lenth C7of lines 1 Trench width 3 , u inches Distance between lines —` 1... Top of tile to finish grade / Material beneath tile/ �� Q Total effective absorption area l0 inches Length Width Depth PERMIT NO. to 7 F IL 2 •: Type of crib Crib diameter Crib depth Total effective absorption area in DISTANCE T0: Well Building f ou -ndation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. a w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) P_ OTHER PIPE MATERIA S C o �JA,fJ (��)c SQA, �( - SOI L TEST RATING` /G7t(ld� INSTALLER �-•� y L J fc% C—::4— r REMARKS v .L / t a'cr. 1, z> QG Flo n °apes oua ° °tz aw5an A' q G. Russell L. Oyster` ,L v, a % L6 ez 0 J° APPROVED DATE LEGAL �a4 /9 r979 R. F IZC,- 1Q "��,"i tl*:��Ii It-: , H .�: :!l II 1,I]�� :��. :if �� DEPHRTMENT O| ,RLTH BND ENVIRONMENTRL F ECTION 825 'L' �TREET, RNCHORHGE/ HK, 995� 264~4720 F :,1! 141131 W A b I' - OG X A - FT Y3 F� Q I lip: FA TV^U to? AU�- t PERMlT NO ( 79011] ) HPPLICHNT WHYNE ESIMMONS PO BOX 551 EHGLERIVER 694 92li LOCHTION CORIEWHY LEGHL LOT 1 HIGHLHND TERR HDD an LOT SIZE 43712 SQUHRE FEET TYPE OF SOIL HBSORBTION SYSTEM ITRENCH MHXIMUM NUMBER OF 8EDROOMS = 4 SOIL RATING (SQ FT/BR)- 140 THE REQUIRE|) SIZE OF THE SOlL HBSORPTION T2M IS: �Kilo �� JI], 11 �541171�1 -1 =: F Q OR F1 ly" FT 0 U. ET FOQ_ 1-0� � PERMIT HPPLICHHT HRS THE RESPONSIBlLIIll TO INFORM THIS DEPRRTMENT DURING THE INSTHLLHTION INSPFCTIONS OF HNY WELLS 1-:10JRCENT TU THIS PROPERTY HND THE 11oUM8ER OF RESIDENCES IRT THE NELL WILL SERVE. ~�� H., K i:::�Il �lj:,. - 11 0 0" KRZ n I - 1 (A ohs S; Val kv? KPI TO H (A 1 .1 1 FQ TH 10 ~ BRCKFILLING OF ANY SYSTEM POUIEP()VHL BY THIS DEPHRTMENT WILL 8E SUBJECT TO PROSECUTION. ��IR owl J. -F �-, F0, I FT IfY ot�.::: 11 UF:;!: ::: 11'^ ] l: I HM FHMlLlHR WITH THE REQUlREMENTS FOR ON~SITE SEWERS HN|) WELLS HS SEl, FORTH 8Y THE MUNlCIPHLITY OF RNCHORHGE. 2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES �� I UNDERSTHND THHT THE ON~SITE SEWER SYSTEM MHY REQUIRE ENL8RGEMENT IF THE 1`0ESl0ENCE I REMODELED TO INCLUDE MORE THHN 4 8EDROOMS SIGNED _--- ISSUED 0 €t E OEO -CHNI CAL & LEVEL ,'MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 6BB-2280 Soils Et Foundations Land Development Performed for: Name: No._f1c/-. `? 'a Mailing Address:' Legal Description: L Fes'_/ � r ,�i« 1�% 74 Depth (feet) Soil Characteristics 0 1 �.-r __-- , T, /7' a �,' 2 3��Cz� � `=_�SnlfJr-(;ai/r_':�" �1G� -.6rj % i 4 5,14',t- i zv� 7 �.. � 8 Ground Mater Encountered: Yes No If yes, what depth,'""" Proposed Inssttaalllation: Seepage Pit Drain Field Cormnents :�/i•� - , 7?4 x.l !9 to Pz-v�j L-WM02 10>CY%f1i x / /J 9/J rs `_1T111 12 13 16 � Ground Mater Encountered: Yes No If yes, what depth,'""" Proposed Inssttaalllation: Seepage Pit Drain Field Cormnents :�/i•� - , 7?4 x.l !9 to Pz-v�j L-WM02 6!> X6' " x / /J c1` Performed by: l r / ' /G y /rig �ti:,ef��z Dater �U .�. % 4_; RETURN 1'0: Division of Geological and ysical Surveys (DGGS) 3001 Porcupine Drive (Tel- re: 277-6615) Anchorage, ,Alaska 99501 Dr 111 frig Company Name LOCATION OF WF.LI. W A 1 E R W E L L R E C O R D Please. complete either la, lb, or Ic. STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES U.S.G.S. Local No. _ _ Drilling Permit No. A.D.L. No. In.^Borough Subdivision Lo[ Block Ib. Fraction Sect No. Township Range Meridian Intersections 3. OWNER OF WELL: Ic. Distance and Direction from Road L Address: Street Address and Area of Well Location 2. WELL LOG Feet Below 4. WELL DEPTH: (completed) Surface Elevation Date of Surface Completion Material Type Top Bottom - 5. ❑1 Cable t<wl ❑ Rotary ❑ Driven ❑ Dug L_1 Auger ❑ Jetted ❑ Do red ❑ Other:v 6. USE: ❑ Domestic ❑ Public Supply ❑ Industry ❑ Irrigation 0 Recharge ❑ Comnerc i al ❑Test Well ❑Other: - - ----"—"—�-- �� 7, CASING: ❑ Threaded ❑ Welded in. to ft. Depth Weight �Tlbs/ft. in. to ft. Depth --- - -- -� 8. FINISH OF WELL: Type: A Diameter: Slot/Mesh Size: Length: Set between ft. and ft. v� - - - d---�-- -- .:4 9, STATIC WATER LEVEL:ft. ❑ Above ❑Below land surface Type of Measurement: - - ---��—'-'--_-'-- 10. PUMPING LEVEL below land surface ft. after �s hrs. pumping v g.p.m. ft. after hrs. pumping g.p.m. ------------� - - - 11. WELL HEAD COMPLETION: ❑ In Approved Pit ❑ Pitless Adapter - inches above grade ��'�� A 12. GROUTING: []Neat lell Grouted: ❑ Yes ❑ No Material: LNeat Cement ❑ Other: - --�— 13. PUMP: (If avallable) HP Length of Drop Pipe ft. capacity a�g.p. Type: ❑ Submersible ❑ Reciprocating ❑ Jet ❑ Other: 14. REMARKS:_--��—�—�- 15. WATER WELL r.ONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief: Registered Busrne ss�Naaw Contract LlcenseNumBer Address: - Signed: Date: Y Authorized Representative Development Services Department O Building Safety Division ..� On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Mark eesich Anchorage. AK 99519-6650 Mayor www mun, ero/nnsite (907)343.7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number:Q5)-31 ("ci3 Legal Descriptioni r 'TEE-TE(—t5 'fes I- A Property Owner Name & Address: Torr Srcc,�2r- /091/- Jac. qJ 4 Pump Installation Date: -^Z C Pump Intake Depth Below Top of Well Casing: 37 Xeet Pump Manufacturer's Name: OJeR !-%eTo R Pump Model: A + Pump Size / .$ by Pitless Adapter Burial Depth: /D feet Pitless Adapter Manufacturer's Name: //,4 Pitless Adapter Installer: A1,4 Well Disinfected Upon Completion? C7 Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: A i^j P� r Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road SNSP.O. Box 1 U Anchorage, AK An99 99507 R www.muni.org/onsite (907)343-7904 FdWJ�=1WER A& CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. v j-31�-3� COSA# (Q qy 1. GENERAL INFORMATION {(&yA^p Expiration Date: Complete legal description Lot 1; Tice subdivision a5 Location (site address) 10925 Corrie Way Eagle River, AK 99577 Current Property owner(s) Wayne & Joyce Simmons Day phone 694-2696 Mailing address same Lending agency Mailing address Real Estate Agent Kathy Geracl Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well R1 Individual Water Storage ❑ Community Class Weil ❑ Public Water System ❑ Day phone Day phone 694-9125 TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑� Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that baseid on the information obtained frorrift Municipality of Anchorage files and from my Investigation and inspectionria op-site water supply an�� ater disposal system is(are) in compliance with all applicable Municipa(dnd State. `codes, ordina = regulafions in effect at the time of installation. of Firm S d S Engineering Phone 694-2979 Address 15W1 S. Birchwood Loop Chugiak. AK)9 7 Engineer's Printed Name / Date L� WDIF.Q_� 5. DSD SIG ATURE•••. Approved for bedrooms. yst �'.'•.._� ,..•'` �� Disapproved. � Conditional approval for bedrooms, with the followingsiip;ibns Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: A -•2 .7 - ais INH IIM) Municipality of Anchorage ' Development Services Department % Building Safety Division On -Site Water & Wastewater Program ' 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON -SUTTEE SYSTEMS APPROVAL CHECKLIST I Legal Description: -Uf I h I(a(awb I Tamm # S Parcel ID: 0.50 — 3 12"3 A. WELL DATA Well tyPezeW rE If A. B, or C provide PWSID # = Well Log;ON) �ES Date completed 415�1 Sanitary seal &) �S Wires properly protected(ON) Total depth 'A` Q_ft. Cased to C_ELft. Casing height (above ground) )0'2 -F in. FROM WE .,LLOG AT INSPECTION Date of test• fJ S � Q r Static water level ft, a l ft Well production Id D g.p.m. 9 -P.M. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate 13- Q mg/L Other bacteria 0 colonies/100 mL Arsenic:ug/L date of sample: !1 �� Collected by: 6t*/K7EW_A)6 B. SEPTICIHOLDING TANK DATA Q� Tank Type/Material S€�n� .� tCC. Date installed D Tank size 1� gal. Number of Compartments Cleanoutsol) y Foundation cleanout Y1) Depression over tank (YD110 High water alarm (Yf_A)n Date of pumping ;a T•22% D'77`' Pumper S ►w111PIA14 t C. ABSORPTION FIELD DATA, —T Dateinstalled1 7'al0S Soil rating (g.p.d.lft2orfelbdrm) 81 System type 5N►ti!D+O Ir2E+ { r r Length �6 ft. Width 5 ft. Gravel below pipe 3,D r Total depth ft. Eff. ab orption area 563ft= Monitor'tube Depression over field �0 Date of adequacy test �Ql Result (Pas aiI 7 r s For bedrooms it of Fluid depth in absorption field before test � In. Water added gal. New depth in. of Elapsed Time:)qqD min. Final fluid depth _L�L in. Absorption rate >= 600t g.p.d. Any rejuvenation treatment (past 12 mo.) (Y&& type) jJ0 If yes, give date D. LIFT STATION NIR Date installed Size in gallons `Pump on' level at_ in. evi Datum Cycles tested E. SEPARATION DISTANCES F. (Y/N) at _ in. High water alarm level at SEPARATION DISTANCES FROM WELL ON LOT TO: i Septic tank/Wfttation on lot 4 r� Absorption field on lot 1� Public sewer main 62111 Sewer /septic service line p2`J / f Animal containment areas Meets alarm & circuit requirements? On adjacent lots !00 r On adjacent lots Public sewer manhole/clea out Holding tank MW Manure/animal excrete storage areas 1C'0 In. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r I r Building foundation 5 Property line 5 r Absorption field 5 r r Water main -AAA-, Water service line /0 i Surface water /6 t Wells on adjacent lots Ir70 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / r / Property line /O Building foundation /D Water main R r � Water Service line 10+ Surface water Driveway, parkingNehicle storage Curtain drain ,gpijf-KR Cxt)K) Wells on adjacent lots �(� 4. G. ENGINEER'S CERTIFICATION I certify that 1 have determined review of Municipal records th conformance with MOA COSA�gt Engineer's Printed Name Date COSA Fee $ ^ 1-16 Date of Payment �2 Receipt Number 645uoD (Rev. I V05) 2 h field inspections and above systems are jp Waiver Fee $ Date of Payment Receipt Number M1 - PRU-1111NARY - SCS Ret# 1084202001 Client Name S $ S Engineering Project Name/# Highland Terrace LI #5 Client Sample ID I lighland Terrace LI #5 1latris Drinking Water PM SID 0 Sample Remarks: Printed Date/Time Collected Date/Time Received Date/Time Technical Director 08252008 10:06 08/112008 12:30 08/112008 13:24 Stephen C. Ede ParameterAllowable Prep Analysis Results Pot Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 Waters Department Total Nitratc/Ninite-N 3.00 0.100 mg/L Sh120 4500NO3-F B (<10) Microbiolow Laboratory Colony Count 0 col/100m], SM209222B A (<200) Total Coliform 0 col/100mL SM209222B A (<II Fecal Coliform 0 col/100mL S1,120922213 A (<l) 0820/08 0822/08 MII 0821/08 JDZ O8/11/08 DLC O8/11/08 DLC 08/11/08 DLC T �ymw. n• /t'_�. Rim .k'^y� 4 I ��r 111 i G I prt✓_0-WA/v � _ P "4 . 1 Le� ZS'± C1j'~ Ay �s 35`'wAY� ly ��' t C t c JT•rP 1 !l 2a. F.. ✓. :. .. � moi. �('�..:.. ,S too a C 'ti ••oP ..� MM•rl LJ A }aiih (pp( t AS -BUILT I hereby certify that I have surveyed the following described property �-Q!-�LZ w_1j Ar Archmage Recordi_g Precinct, Alaska, and that the improvements situated thereon are within the prorev lines and de net ovsrl•,p or encroach on the property I IYirr a3jzccnt thrreto, that no improvements on prop- erly lying adjacent thereto encrosch oa the premises in question and thA there are r.oroad a•ays. tram:,nission 1 Encs or whrr vis.ble easements on sajd'prcperty except as indicidcLi hereon. tWed at Engle R-� er, Alaska � ROBERT C. JOHNSON REC., SCALE' IQ0G !ert.•d Land Sur•evor I`lo. t'.0 -LS 40' Box 956, Eagle River, Alaska Picone 694-00,543 1 AUG/07/200?/THHU 07:06 FY FAX No. P.002 Eagle River Engineering Services 10421 VFW Rd Sdte 201 ChdA pher R Wood, P.E. Eagir Riva, AIC 99577 (907) 694-5195 Q (907) 694.3297 Gr WELL a SEPTIC ADEQUACY TEST REPORT TESTDATE: 9x282007 LEGAL. Highland Terracc#5 Llot I LOCATTON: 10925 Corrie way. RESIDENCE: Single Family, 4 Bedrooms WELL YIELD: 1.4 Gallons per Minute now rate WATER SYSTEM: Private well WATER SAMPLES: None taken SEPTIC SYSTEM: From Municipal Records Tenk:1250 gallon Absorption System: 5'X 66' drainfield INSTALLATION DATE: 7292005 INSTALLED ABSORPTION AREA 563 SquareFeet ORIGINAL SOIL RATING: 0.8 gpd/sgft, From Engineer's Design TEST PROCEDURE The leacbfield consists of a 5'X 66' wide draintield with 3' effective gravel. The leachfield was charged with water from the on-site well at an average rate of 22 GPM for a total of 600 gallons. The septic tank and leachfield liquid levels were monitored referencing a measurement below the top of the standpipes. During the test, water was added through the after tank cleanout tube and the leachfield water level was monitored as water was added and then absorbed into the surrounding soil There w in the field at the start of the test. After the addition of 600 gallons of watas 0" Of water standing y the water leve) rose to 6". After 24 boon the water table ble had dropped to 0 -above the bottom of the trench. The water level In the septic tank did not rise during the addition of 600 gallons of water showing tb#t I the leachfrcld had accepted the entire amount. This Indicates the septic system will accept the required, I50 gallons per day of effluent, per bedroom, which is the required absorption rate for MOA approval, 12003107-098majaA m>m vmDoc Pere I oft PAX No. P. 003 SLI The well was pumped into the septic system. Total drawdown from a static water level of 29 feet was 93 feet, after 30 minutes of pumping at an average flow rate of 7 gallons per minute. The flow was then reduced to 1.4 gpm, causing the water level in the casing to stabilize for the remainder of the test This indicates a well production rate of 1.4 gallons per minute. This flow rate exceeds MOA's minimum requirements for private well water production. TEST RESULTS The septic system absorption rate and well flow rate exceed the basic requirements of the Municipality of Anchorage for a 4 bedroom single family residence as of the day the system was tested. CONDMONS: Assessment of existing subsurface conditions by the inspecting engineer is limited to information obtained from the available monitoring tubes and Municipal re rd search We do not Guarantee the validity, accuracy or quality of subsurface tests and inspections performed by the original inspecting engineer or authority. This report is limited to absorption rate testing and surface separation measurements as currently required by the Municipality of Anchorage and does not verify the integrity of the piping for the water supply or water quality other than the bacterial and nitrate content The operational life and the matter er of compliance with State and Municipal codes, for all water and septic systems depends on the local soil conditions, groundwater levels that may not be observed from the surface without additional testing, water usage of the homes being served by the system, and the detail of required testing procedure. There is no guarantee that the well and septic system tested will meet the requirements for approval in the future. The test data and investigation of existing conditions is provided to our client for submittal to the Municipality Health Department for their review and approval. Any concerns with this test report should be discussed with the testing engineer. If it is requested we will submit the report directly to the Municipality. 12003107-098 mmawam 7saxAcE we Page 2 of 2 Nn7F 0;4a n LA22�� INSPECTION APPOINTMENTS -DATE RECEIVED TIME TIME TIME r� DATE DATE DATTE 4-1 01 A!/A.5. INSPECTOR INSPECTOR - - - - INSP CTR 7. WATER SUPPLY �-J * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY MUNICIPALITY Of: ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE 'TEPT. OF I' P,Cfi I £< NMEf IAL i ,.;..! I LOTION 825 L Street - Anchorage, Alaska 99501 O ENVIRONMENTAL SANITATION DIVISION MAR 1980 Telephone 264.4720 (' F �% REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE9A`F-WIV199 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP RTY.O NEAR/�'— YH/O/NE - MAI LING A D DR SS r POPE'TY RESIDENT (If different from above) - C.�� rz', IS -- PHONE 2. BUYER t � �/ PHMNE �L A/ 4M U M MAILING AD19VD ESS / 3. LENDING INSTITUTION - - - PHONE �� MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION _�—� �o _, '/ / 4. STREET LOCATION 6. TYPE OF RESIDENCE I NUMBER OF,BEDROOMS —i�— J SINGLE FAMILY ❑ One 14 Four ❑ Other _ ❑ MULTIPLE FAMILY ❑ Two ❑ Five ❑ Three ❑ Six 7. WATER SUPPLY ;. INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** AlYEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILII-Y NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) rJ s'' E THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified_LOG PERMIT NUMBER DEPTH OF WELL DATE DRILLED RECEIVED }} 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER A ,x.,_).r,t2,:- ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS D,. --APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BYLl E